NY DFS Section 345 · Commercial Claims

NY Commercial Denial Rate Trends

Tier 1 Filers  ·  Aetna Life, Excellus, Highmark, CDPHP (×2), MVP (×2), Independent Health (×2), HIP/EmblemHealth  ·  Pharmacy excluded  ·  Q1 2022 – Q3 2025
Chart 1
All-Category Denial Rate — Quarterly
Volume-weighted (headline) and simple average across 10 Tier 1 filers
Vol-weighted avg
Flat avg
Chart 2
Denial Rate by Provider Category — Quarterly
Volume-weighted (headline) and simple average across 10 Tier 1 filers
Category
Vol-weighted avg
Flat avg
Chart 3 · Tier 1 (10 filers)
Denial Reasons — Full Denial Rate
T3 reason composition scaled to T1 full denial rate — bar heights match Chart 2 vol-weighted values
Category